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Biomedical subjects

P Zucchelli

Publications and source records attributed to P Zucchelli.

249 records · Page 14Linked to original sources
PubMedDate not supplied

Hypertension in end-stage renal failure: role of sympathetic nervous system, sodium balance and renal pressor system.

120 subjects, including 16 normal volunteers, 23 essential hypertensive and 81 uraemic patients (34 before the start of haemodialysis and 47 during maintenance haemodialysis) were studied in order to evaluate the interrelationship between mean arterial pressure (MAP) and total exchangeable sodium (NaE), plasma renin activity (PRA) and plasma catecholamines (PC). Significant positive correlations were noted between MAP and PRA and between MAP and PC in the total group of uraemic patients. In patients under conservative treatment MAP correlated significantly with NaE and PRA. Multiple regression analysis demonstrated that the combined effect of NaE and PRA accounted for 50 per cent of the levels of MAP. In patients undergoing chronic haemodialysis MAP lost any correlation with NaE. In these patients the presence of hypertension seemed to be related to the values of PRA and PC. PC increased after two hours of walking and hypertensive patients had higher increments than normotensive patients. These data might support an important role for the adrenergic system in the maintenance of hypertension in dialysis patients.

Adolescent↗
PubMedDate not supplied

The rationale for plasmapheresis in renal graft rejection.

The present study reports on 15 transplanted patients with acute vascular rejection unresponsive to high-dose steroids, who underwent plasmapheresis treatment. Cyclophosphamide was combined with plasmapheresis in 11 patients in whom specific anti-HLA antibodies against the donor's mismatched antigens were detected. The treatment proved effective in removing the antibodies from circulation and in improving the graft function. Nine of these patients have a well-functioning graft 3 to 24 months after treatment. Plasmapheresis failed to reverse rejection in two out of the four patients where anti-HLA antibodies were not found, while the remainder have a satisfactory renal function after 18 and 32 months respectively. We conclude that in transplanted patients plasmapheresis associated with an appropriate immunosuppressive therapy may be of value in the treatment of acute vascular rejection that is unresponsive to high-dose steroids, particularly when specific anti-HLA antibodies are detected.

Antibodies, Anti-Idiotypic↗
PubMedDate not supplied

The kidney as a victim of essential hypertension.

Over the past decade the prevalence of end stage renal disease has risen progressively in industrialized societies. According to the data of renal disease Registries hypertensive nephrosclerosis appears to be a very important cause of progressive renal disease. However epidemiological data on the risk of hypertensive patients to develop renal failure offer contrasting results. In observational longitudinal studies a higher rate of decline in renal function is generally found in hypertensive compared to normotensive subjects. On the other hand, the inability of antihypertensive therapy to influence kidney destiny emerges from the large majority of interventional studies on mild-moderate hypertension in caucasian patients. At variance, the role of hypertension as etiologic factor seems to be sufficiently clear in African Americ: hypertension is more common, more severe and less easily to handle in a black patients. It is probable that the diagnosis of hypertensive nephrosclerosis is a confounding label laidon a heterogeneous group of diseases comprising a true hypertensive nephropathy (typical of black patients) along with occlusive or atheroembolic diseases common in aged caucasian patients. Our future efforts will have to be directed towards better identifying and properly classifying the various subgroup in order to optimize the treatment and prevent renal failure.

Aged↗